|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$539.47
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$329.02 |
| Max. Negotiated Rate |
$485.52 |
| Rate for Payer: Aetna Commercial |
$458.55
|
| Rate for Payer: BCBS Trust/PPO |
$416.90
|
| Rate for Payer: BCN Commercial |
$416.90
|
| Rate for Payer: Cash Price |
$431.58
|
| Rate for Payer: Cofinity Commercial |
$463.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.58
|
| Rate for Payer: Healthscope Commercial |
$485.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$404.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.55
|
| Rate for Payer: PHP Commercial |
$458.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.73
|
| Rate for Payer: UHC Core |
$450.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$404.60
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,818.21 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,105.12
|
| Rate for Payer: BCN Commercial |
$6,105.12
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,876.25 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,054.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,468.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,468.75
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,975.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,142.25
|
| Rate for Payer: BCN Commercial |
$6,142.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,975.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,975.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,073.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,271.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,876.25
|
| Rate for Payer: PACE SWMI |
$1,975.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,975.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Medicare |
$1,975.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,975.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,975.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,034.25
|
| Rate for Payer: VA VA |
$1,975.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$299.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.31
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$288.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.45
|
| Rate for Payer: BCN Commercial |
$896.45
|
| Rate for Payer: BCN Medicare Advantage |
$288.25
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.25
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Senior Care Partners |
$273.84
|
| Rate for Payer: PACE SWMI |
$288.25
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$288.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Medicare |
$288.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: Railroad Medicare Medicare |
$288.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.89
|
| Rate for Payer: VA VA |
$288.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.21 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.03
|
| Rate for Payer: BCN Commercial |
$891.03
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$299.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.31
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$288.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.45
|
| Rate for Payer: BCN Commercial |
$896.45
|
| Rate for Payer: BCN Medicare Advantage |
$288.25
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.25
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Senior Care Partners |
$273.84
|
| Rate for Payer: PACE SWMI |
$288.25
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$288.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Medicare |
$288.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: Railroad Medicare Medicare |
$288.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.89
|
| Rate for Payer: VA VA |
$288.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.21 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.03
|
| Rate for Payer: BCN Commercial |
$891.03
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$299.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.31
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$288.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.45
|
| Rate for Payer: BCN Commercial |
$896.45
|
| Rate for Payer: BCN Medicare Advantage |
$288.25
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.25
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Senior Care Partners |
$273.84
|
| Rate for Payer: PACE SWMI |
$288.25
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$288.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Medicare |
$288.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: Railroad Medicare Medicare |
$288.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.89
|
| Rate for Payer: VA VA |
$288.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.21 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.03
|
| Rate for Payer: BCN Commercial |
$891.03
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$299.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.31
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$288.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.45
|
| Rate for Payer: BCN Commercial |
$896.45
|
| Rate for Payer: BCN Medicare Advantage |
$288.25
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.25
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Senior Care Partners |
$273.84
|
| Rate for Payer: PACE SWMI |
$288.25
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$288.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Medicare |
$288.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: Railroad Medicare Medicare |
$288.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.89
|
| Rate for Payer: VA VA |
$288.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.21 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.03
|
| Rate for Payer: BCN Commercial |
$891.03
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,904.19
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,161.37 |
| Max. Negotiated Rate |
$1,713.77 |
| Rate for Payer: Aetna Commercial |
$1,618.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.56
|
| Rate for Payer: BCN Commercial |
$1,471.56
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,637.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.35
|
| Rate for Payer: Healthscope Commercial |
$1,713.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,428.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: PHP Commercial |
$1,618.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,656.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,161.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,675.69
|
| Rate for Payer: UHC Core |
$1,590.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,428.14
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,904.19
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.25 |
| Max. Negotiated Rate |
$1,713.77 |
| Rate for Payer: Aetna Commercial |
$1,618.56
|
| Rate for Payer: Aetna Medicare |
$495.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.06
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$476.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.51
|
| Rate for Payer: BCN Commercial |
$1,480.51
|
| Rate for Payer: BCN Medicare Advantage |
$476.05
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,637.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.05
|
| Rate for Payer: Healthscope Commercial |
$1,713.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,428.14
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: PACE Senior Care Partners |
$452.25
|
| Rate for Payer: PACE SWMI |
$476.05
|
| Rate for Payer: PHP Commercial |
$1,618.56
|
| Rate for Payer: PHP Medicare Advantage |
$476.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,656.65
|
| Rate for Payer: Priority Health Medicare |
$476.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,161.37
|
| Rate for Payer: Railroad Medicare Medicare |
$476.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,675.69
|
| Rate for Payer: UHC Core |
$1,590.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.05
|
| Rate for Payer: UHC Medicare Advantage |
$490.33
|
| Rate for Payer: VA VA |
$476.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,428.14
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
IP
|
$1,904.19
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,161.37 |
| Max. Negotiated Rate |
$1,713.77 |
| Rate for Payer: Aetna Commercial |
$1,618.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.56
|
| Rate for Payer: BCN Commercial |
$1,471.56
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,637.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.35
|
| Rate for Payer: Healthscope Commercial |
$1,713.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,428.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: PHP Commercial |
$1,618.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,656.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,161.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,675.69
|
| Rate for Payer: UHC Core |
$1,590.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,428.14
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
OP
|
$1,904.19
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.25 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$1,618.56
|
| Rate for Payer: Aetna Medicare |
$495.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.06
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$476.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.51
|
| Rate for Payer: BCN Commercial |
$1,480.51
|
| Rate for Payer: BCN Medicare Advantage |
$476.05
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,637.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.05
|
| Rate for Payer: Healthscope Commercial |
$1,713.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,428.14
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: PACE Senior Care Partners |
$452.25
|
| Rate for Payer: PACE SWMI |
$476.05
|
| Rate for Payer: PHP Commercial |
$1,618.56
|
| Rate for Payer: PHP Medicare Advantage |
$476.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,656.65
|
| Rate for Payer: Priority Health Medicare |
$476.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,161.37
|
| Rate for Payer: Railroad Medicare Medicare |
$476.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,675.69
|
| Rate for Payer: UHC Core |
$1,590.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.05
|
| Rate for Payer: UHC Medicare Advantage |
$490.33
|
| Rate for Payer: VA VA |
$476.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,428.14
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$822.28
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.29 |
| Max. Negotiated Rate |
$740.05 |
| Rate for Payer: Aetna Commercial |
$698.94
|
| Rate for Payer: Aetna Medicare |
$213.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$256.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$256.96
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$205.57
|
| Rate for Payer: BCBS Trust/PPO |
$639.32
|
| Rate for Payer: BCN Commercial |
$639.32
|
| Rate for Payer: BCN Medicare Advantage |
$205.57
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cofinity Commercial |
$707.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$657.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.57
|
| Rate for Payer: Healthscope Commercial |
$740.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$616.71
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$215.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$236.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$698.94
|
| Rate for Payer: PACE Senior Care Partners |
$195.29
|
| Rate for Payer: PACE SWMI |
$205.57
|
| Rate for Payer: PHP Commercial |
$698.94
|
| Rate for Payer: PHP Medicare Advantage |
$205.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.38
|
| Rate for Payer: Priority Health Medicare |
$205.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$501.51
|
| Rate for Payer: Railroad Medicare Medicare |
$205.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$723.61
|
| Rate for Payer: UHC Core |
$686.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.57
|
| Rate for Payer: UHC Medicare Advantage |
$211.74
|
| Rate for Payer: VA VA |
$205.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$616.71
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$822.28
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$501.51 |
| Max. Negotiated Rate |
$740.05 |
| Rate for Payer: Aetna Commercial |
$698.94
|
| Rate for Payer: BCBS Trust/PPO |
$635.46
|
| Rate for Payer: BCN Commercial |
$635.46
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cofinity Commercial |
$707.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$657.82
|
| Rate for Payer: Healthscope Commercial |
$740.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$616.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$698.94
|
| Rate for Payer: PHP Commercial |
$698.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$501.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$723.61
|
| Rate for Payer: UHC Core |
$686.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$616.71
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$358.81 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: BCBS Trust/PPO |
$454.65
|
| Rate for Payer: BCN Commercial |
$454.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$152.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.85
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$147.08
|
| Rate for Payer: BCBS Trust/PPO |
$457.41
|
| Rate for Payer: BCN Commercial |
$457.41
|
| Rate for Payer: BCN Medicare Advantage |
$147.08
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.08
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Senior Care Partners |
$139.72
|
| Rate for Payer: PACE SWMI |
$147.08
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: PHP Medicare Advantage |
$147.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Medicare |
$147.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: Railroad Medicare Medicare |
$147.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.08
|
| Rate for Payer: UHC Medicare Advantage |
$151.49
|
| Rate for Payer: VA VA |
$147.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
IP
|
$1,268.88
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$773.89 |
| Max. Negotiated Rate |
$1,141.99 |
| Rate for Payer: Aetna Commercial |
$1,078.55
|
| Rate for Payer: BCBS Trust/PPO |
$980.59
|
| Rate for Payer: BCN Commercial |
$980.59
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cofinity Commercial |
$1,091.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.10
|
| Rate for Payer: Healthscope Commercial |
$1,141.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$951.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,078.55
|
| Rate for Payer: PHP Commercial |
$1,078.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$773.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,116.61
|
| Rate for Payer: UHC Core |
$1,059.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.66
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
OP
|
$1,268.88
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$301.36 |
| Max. Negotiated Rate |
$1,141.99 |
| Rate for Payer: Aetna Commercial |
$1,078.55
|
| Rate for Payer: Aetna Medicare |
$329.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$396.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$396.52
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$317.22
|
| Rate for Payer: BCBS Trust/PPO |
$986.55
|
| Rate for Payer: BCN Commercial |
$986.55
|
| Rate for Payer: BCN Medicare Advantage |
$317.22
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cofinity Commercial |
$1,091.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.22
|
| Rate for Payer: Healthscope Commercial |
$1,141.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$951.66
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$333.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$364.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,078.55
|
| Rate for Payer: PACE Senior Care Partners |
$301.36
|
| Rate for Payer: PACE SWMI |
$317.22
|
| Rate for Payer: PHP Commercial |
$1,078.55
|
| Rate for Payer: PHP Medicare Advantage |
$317.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.93
|
| Rate for Payer: Priority Health Medicare |
$317.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$773.89
|
| Rate for Payer: Railroad Medicare Medicare |
$317.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,116.61
|
| Rate for Payer: UHC Core |
$1,059.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.22
|
| Rate for Payer: UHC Medicare Advantage |
$326.74
|
| Rate for Payer: VA VA |
$317.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.66
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$299.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.31
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$288.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.45
|
| Rate for Payer: BCN Commercial |
$896.45
|
| Rate for Payer: BCN Medicare Advantage |
$288.25
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.25
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Senior Care Partners |
$273.84
|
| Rate for Payer: PACE SWMI |
$288.25
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$288.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Medicare |
$288.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: Railroad Medicare Medicare |
$288.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.89
|
| Rate for Payer: VA VA |
$288.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.21 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.03
|
| Rate for Payer: BCN Commercial |
$891.03
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,383.59
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$328.60 |
| Max. Negotiated Rate |
$1,245.23 |
| Rate for Payer: Aetna Commercial |
$1,176.05
|
| Rate for Payer: Aetna Medicare |
$359.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$432.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$432.37
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$345.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,075.74
|
| Rate for Payer: BCN Commercial |
$1,075.74
|
| Rate for Payer: BCN Medicare Advantage |
$345.90
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cofinity Commercial |
$1,189.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.90
|
| Rate for Payer: Healthscope Commercial |
$1,245.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.69
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$363.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$397.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,176.05
|
| Rate for Payer: PACE Senior Care Partners |
$328.60
|
| Rate for Payer: PACE SWMI |
$345.90
|
| Rate for Payer: PHP Commercial |
$1,176.05
|
| Rate for Payer: PHP Medicare Advantage |
$345.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$968.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,203.72
|
| Rate for Payer: Priority Health Medicare |
$345.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$843.85
|
| Rate for Payer: Railroad Medicare Medicare |
$345.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,217.56
|
| Rate for Payer: UHC Core |
$1,155.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.90
|
| Rate for Payer: UHC Medicare Advantage |
$356.27
|
| Rate for Payer: VA VA |
$345.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.69
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,383.59
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$843.85 |
| Max. Negotiated Rate |
$1,245.23 |
| Rate for Payer: Aetna Commercial |
$1,176.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.24
|
| Rate for Payer: BCN Commercial |
$1,069.24
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cofinity Commercial |
$1,189.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.87
|
| Rate for Payer: Healthscope Commercial |
$1,245.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,176.05
|
| Rate for Payer: PHP Commercial |
$1,176.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$968.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,203.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$843.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,217.56
|
| Rate for Payer: UHC Core |
$1,155.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.69
|
|
